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Autor Fabián Alberto Jaimes Barragán
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Médico Epidemiólogo PHD, Hospital Pablo Tobón Uribe
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Documentos disponibles escritos por este autor (70)
Refinar búsquedaPositive culture and prognosis in patients with sepsis: a prospective cohort study / Fabián Alberto Jaimes Barragán
Título : Positive culture and prognosis in patients with sepsis: a prospective cohort study Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2020 Títulos uniformes : Journal of Intensive Care Medicine Idioma : Inglés (eng) Palabras clave : Blood culture epidemiology microbiological culture mortality sepsis Resumen : Purpose: To analyze the prognostic role of positive cultures in patients with sepsis. Methods: A prospective cohort study in a tertiary referral hospital in Medellín, Colombia. Adults older than 18 years of age with a bacterial infection diagnosis according to Centers for Disease Control criteria and sepsis (evidence of organ dysfunction) were included. A logistic regression model was used to determine the association between positive cultures and hospital mortality, and a Cox regression with a competing risk modeling approach was used to determine the association between positive cultures and hospital stay as well as secondary infections. Results: Overall, 408 patients had positive cultures, of which 257 were blood culture, and 153 had negative cultures. Patients with positive cultures had a lower risk of mortality (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.27-0.68), but this association was not maintained after adjusting for confounding factors (OR, 0.56; 95% CI, 0.31-1.01). No association was found with the hospital stay (adjusted subhazard ratio [SHR], 1.06; 95% CI, 0.83-1.35). There was no association between positive cultures and the presence of secondary infections (adjusted SHR, 0.99; 95% CI, 0.58-1.71). Conclusion: Positive cultures are not associated with prognosis in patients with sepsis. Mención de responsabilidad : Fernando Molina, Pablo Castaño, Maribel Plaza, Carolina Hincapié, Wilmar Maya, Juan Carlos Cataño, Javier González, Alba León, Fabián Jaimes Referencia : J Intensive Care Med. 2020 Aug;35(8):755-762. DOI (Digital Object Identifier) : 10.1177/0885066618783656 PMID : 29925284 En línea : https://journals.sagepub.com/doi/abs/10.1177/0885066618783656?journalCode=jica Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4696 Positive culture and prognosis in patients with sepsis: a prospective cohort study [documento electrónico] / Fabián Alberto Jaimes Barragán, . - 2020.
Obra : Journal of Intensive Care Medicine
Idioma : Inglés (eng)
Palabras clave : Blood culture epidemiology microbiological culture mortality sepsis Resumen : Purpose: To analyze the prognostic role of positive cultures in patients with sepsis. Methods: A prospective cohort study in a tertiary referral hospital in Medellín, Colombia. Adults older than 18 years of age with a bacterial infection diagnosis according to Centers for Disease Control criteria and sepsis (evidence of organ dysfunction) were included. A logistic regression model was used to determine the association between positive cultures and hospital mortality, and a Cox regression with a competing risk modeling approach was used to determine the association between positive cultures and hospital stay as well as secondary infections. Results: Overall, 408 patients had positive cultures, of which 257 were blood culture, and 153 had negative cultures. Patients with positive cultures had a lower risk of mortality (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.27-0.68), but this association was not maintained after adjusting for confounding factors (OR, 0.56; 95% CI, 0.31-1.01). No association was found with the hospital stay (adjusted subhazard ratio [SHR], 1.06; 95% CI, 0.83-1.35). There was no association between positive cultures and the presence of secondary infections (adjusted SHR, 0.99; 95% CI, 0.58-1.71). Conclusion: Positive cultures are not associated with prognosis in patients with sepsis. Mención de responsabilidad : Fernando Molina, Pablo Castaño, Maribel Plaza, Carolina Hincapié, Wilmar Maya, Juan Carlos Cataño, Javier González, Alba León, Fabián Jaimes Referencia : J Intensive Care Med. 2020 Aug;35(8):755-762. DOI (Digital Object Identifier) : 10.1177/0885066618783656 PMID : 29925284 En línea : https://journals.sagepub.com/doi/abs/10.1177/0885066618783656?journalCode=jica Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4696 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001170 AC-2018-109 Archivo digital Producción Científica Artículos científicos Disponible
Título : Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2019 Títulos uniformes : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : Antibacterial agents hospital mortality length of stay shock Resumen : Objective: To assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies. Methods: Prospective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted. Results: A total of 705 patients with severe sepsis were included. No differences were found in positive-culture patients (n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics (OR = 0.90; 95% CI = 0.55-1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive (OR = 1.04; 95% CI = 0.99-1.08) or negative cultures (OR = 0.98; 95% CI = 0.92-1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7-18 days for the whole cohort). Conclusions: No associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay Mención de responsabilidad : Pablo Castaño, Maribel Plaza, Fernando Molina, Carolina Hincapié, Wilmar Maya, Juan Cataño, Javier González, Alba León, Fabián Jaimes Referencia : Trop Med Int Health. 2019 Feb;24(2):175-184 DOI (Digital Object Identifier) : 10.1111/tmi.13186 PMID : 30489005 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/tmi.13186 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4266 Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock [documento electrónico] / Fabián Alberto Jaimes Barragán, . - 2019.
Obra : Tropical Medicine & International Health
Idioma : Inglés (eng)
Palabras clave : Antibacterial agents hospital mortality length of stay shock Resumen : Objective: To assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies. Methods: Prospective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted. Results: A total of 705 patients with severe sepsis were included. No differences were found in positive-culture patients (n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics (OR = 0.90; 95% CI = 0.55-1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive (OR = 1.04; 95% CI = 0.99-1.08) or negative cultures (OR = 0.98; 95% CI = 0.92-1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7-18 days for the whole cohort). Conclusions: No associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay Mención de responsabilidad : Pablo Castaño, Maribel Plaza, Fernando Molina, Carolina Hincapié, Wilmar Maya, Juan Cataño, Javier González, Alba León, Fabián Jaimes Referencia : Trop Med Int Health. 2019 Feb;24(2):175-184 DOI (Digital Object Identifier) : 10.1111/tmi.13186 PMID : 30489005 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/tmi.13186 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4266 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001245 AC-2019-034 Archivo digital Producción Científica Artículos científicos Disponible 
Título : Características de los pacientes adultos con neutropenia febril en un hospital universitario (Medellín, 2012-2016) Otros títulos : Characteristics of adult patients with febrile neutropenia in a university hospital (Medellin, 2012-2016) Tipo de documento : documento electrónico Autores : Tatiana Arroyave Peña, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2019 Títulos uniformes : Medicina U.P.B. Idioma : Español (spa) Palabras clave : neutropenia febril oncología médica bacterias antibacterianos Resumen : Objetivo: la neutropenia febril es una urgencia médica que se presenta frecuentemente en pacientes con inmunosupresión asociada a tratamientos oncológicos, que aumenta el riesgo de complicaciones infecciosas y de morir. El objetivo de esta investigación es describir las características clínicas, microbiológicas y pronósticas de los pacientes con neutropenia febril en un hospital universitario. Metodología: estudio observacional descriptivo, entre enero de 2012 y junio de 2016, en pacientes con diagnóstico de neutropenia febril (neutrófilos menores de 500 cel/mm, temperatura mayor de 38 °C) hospitalizados en el Hospital Pablo Tobón Uribe de Medellín, Colombia. Resultados: se evaluaron 226 pacientes con neutropenia febril, de los que el 96% tenía enfermedad oncológica de base. Las principales fuentes de infección fueron la piel y el tracto gastrointestinal. Del total de los hemocultivos, el 31% fue positivo. El principal aislamiento fue Escherichia coli (E. coli) y la mortalidad hospitalaria fue del 17%. Conclusiones: las características clínicas de la población fueron similares a las de la literatura internacional. Se encontraron algunas discrepancias en cuanto a epidemiología de los microorganismos aislados, resistencia microbiana y mortalidad. Solo un tercio de los pacientes presentó bacteriemia, E. coli sigue siendo el principal patógeno. Mención de responsabilidad : Tatiana Arroyave-Peña, José David Puerta-Rojas, Rafael Eduardo Beltrán-Benavidez, Tania Margarita Salgado-Gómez, Diana Carolina Ramírez-Cadavid, David Arroyave-Ávila, Ana Camila Ruiz-Ceballos, Luisa Fernanda Londoño-Aguilar, Fabián Alberto Jaimes-Barragán Referencia : Med UPB. 2019;38(2):108-113 DOI (Digital Object Identifier) : 10.18566/medupb.v38n2.a02 Derechos de uso : CC BY En línea : https://revistas.upb.edu.co/index.php/medicina/article/view/586 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4269 Características de los pacientes adultos con neutropenia febril en un hospital universitario (Medellín, 2012-2016) = Characteristics of adult patients with febrile neutropenia in a university hospital (Medellin, 2012-2016) [documento electrónico] / Tatiana Arroyave Peña, ; Fabián Alberto Jaimes Barragán, . - 2019.
Obra : Medicina U.P.B.
Idioma : Español (spa)
Palabras clave : neutropenia febril oncología médica bacterias antibacterianos Resumen : Objetivo: la neutropenia febril es una urgencia médica que se presenta frecuentemente en pacientes con inmunosupresión asociada a tratamientos oncológicos, que aumenta el riesgo de complicaciones infecciosas y de morir. El objetivo de esta investigación es describir las características clínicas, microbiológicas y pronósticas de los pacientes con neutropenia febril en un hospital universitario. Metodología: estudio observacional descriptivo, entre enero de 2012 y junio de 2016, en pacientes con diagnóstico de neutropenia febril (neutrófilos menores de 500 cel/mm, temperatura mayor de 38 °C) hospitalizados en el Hospital Pablo Tobón Uribe de Medellín, Colombia. Resultados: se evaluaron 226 pacientes con neutropenia febril, de los que el 96% tenía enfermedad oncológica de base. Las principales fuentes de infección fueron la piel y el tracto gastrointestinal. Del total de los hemocultivos, el 31% fue positivo. El principal aislamiento fue Escherichia coli (E. coli) y la mortalidad hospitalaria fue del 17%. Conclusiones: las características clínicas de la población fueron similares a las de la literatura internacional. Se encontraron algunas discrepancias en cuanto a epidemiología de los microorganismos aislados, resistencia microbiana y mortalidad. Solo un tercio de los pacientes presentó bacteriemia, E. coli sigue siendo el principal patógeno. Mención de responsabilidad : Tatiana Arroyave-Peña, José David Puerta-Rojas, Rafael Eduardo Beltrán-Benavidez, Tania Margarita Salgado-Gómez, Diana Carolina Ramírez-Cadavid, David Arroyave-Ávila, Ana Camila Ruiz-Ceballos, Luisa Fernanda Londoño-Aguilar, Fabián Alberto Jaimes-Barragán Referencia : Med UPB. 2019;38(2):108-113 DOI (Digital Object Identifier) : 10.18566/medupb.v38n2.a02 Derechos de uso : CC BY En línea : https://revistas.upb.edu.co/index.php/medicina/article/view/586 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4269 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001248 AC-2019-038 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
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Título : Development and Internal Validation of a Prediction Model to Estimate the Probability of Needing Aggressive Immunosuppressive Therapy With Cytostatics in de Novo Lupus Nephritis Patients Otros títulos : Desarrollo y validación interna de un modelo de predicción para estimar la probabilidad de requerir inmunosupresión intensiva con citostáticos en pacientes con nefritis lúpica de novo Tipo de documento : documento electrónico Autores : Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2019 Títulos uniformes : Reumatología Clínica Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus lupus nephritis immunosuppression multivariate analysis decision support techniques logistic models Resumen : Objective: To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies. Methods: Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model. Goodness of fit was evaluated using a Hosmer–Lemeshow test (H–L) and the discrimination capacity of the model by means of the area under the ROC (AUC) curve. Results: Data from 242 patients was gathered; of these, 18.2% (n = 44) did not need an addition of cytostatics according to the findings of their kidney biopsies. The variables included in the final model were 24-h proteinuria, diastolic blood pressure, creatinine, C3 complement and the interaction of hematuria with leukocyturia in urinary sediment. The model showed excellent discrimination (AUC = 0.929; 95% CI = 0.894–0.963) and adequate calibration (H–L, P = .959). Conclusion: In recent-onset LN patients, the decision to use or not to use intensive immunosuppressive therapy could be performed based on our prediction model as an alternative to kidney biopsies. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula Andrea Granda-Carvajal, Fabián Jaimes Referencia : Reumatol Clin. 2019 Jan - Feb;15(1):27-33. DOI (Digital Object Identifier) : 10.1016/j.reuma.2017.05.010 PMID : 28732643 En línea : https://www.reumatologiaclinica.org/en-linkresolver-development-internal-validat [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4052 Development and Internal Validation of a Prediction Model to Estimate the Probability of Needing Aggressive Immunosuppressive Therapy With Cytostatics in de Novo Lupus Nephritis Patients = Desarrollo y validación interna de un modelo de predicción para estimar la probabilidad de requerir inmunosupresión intensiva con citostáticos en pacientes con nefritis lúpica de novo [documento electrónico] / Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán, . - 2019.
Obra : Reumatología Clínica
Idioma : Inglés (eng)
Palabras clave : Systemic lupus erythematosus lupus nephritis immunosuppression multivariate analysis decision support techniques logistic models Resumen : Objective: To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies. Methods: Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model. Goodness of fit was evaluated using a Hosmer–Lemeshow test (H–L) and the discrimination capacity of the model by means of the area under the ROC (AUC) curve. Results: Data from 242 patients was gathered; of these, 18.2% (n = 44) did not need an addition of cytostatics according to the findings of their kidney biopsies. The variables included in the final model were 24-h proteinuria, diastolic blood pressure, creatinine, C3 complement and the interaction of hematuria with leukocyturia in urinary sediment. The model showed excellent discrimination (AUC = 0.929; 95% CI = 0.894–0.963) and adequate calibration (H–L, P = .959). Conclusion: In recent-onset LN patients, the decision to use or not to use intensive immunosuppressive therapy could be performed based on our prediction model as an alternative to kidney biopsies. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula Andrea Granda-Carvajal, Fabián Jaimes Referencia : Reumatol Clin. 2019 Jan - Feb;15(1):27-33. DOI (Digital Object Identifier) : 10.1016/j.reuma.2017.05.010 PMID : 28732643 En línea : https://www.reumatologiaclinica.org/en-linkresolver-development-internal-validat [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4052 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000652 AC-2017-041 Archivo digital Producción Científica Artículos científicos Disponible
Título : Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality Tipo de documento : documento electrónico Autores : Jessica María Londoño Agudelo, ; Elisa Bernal Sierra, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2018 Títulos uniformes : Shock Idioma : Inglés (eng) Palabras clave : Hyperlactatemia lactic acid multiple trauma oxygen consumption patient outcome assessment resuscitation sepsis shock vasopressors Resumen : Background: Lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination may replace it as screening tool. We have determined the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 h of resuscitation; and the association between clinical parameters, lactate, and mortality. Methods: Prospective cohort study of adult patients hospitalized in the emergency room with infection, polytrauma, or other causes of hypotension. We measured serum lactate, capillary refill time, shock index, and pulse pressure at 0, 6, and 24 h after admission. A Spearman's correlation was performed between clinical variables and lactate levels, as well as between changes in clinical parameters and lactate clearance. The operative characteristics of these variables were determined by area under the receiver operating characteristic curve analysis and the association between lactate, clinical variables, and mortality through logistic regression. Results: A total of 1,320 patients met the inclusion criteria, 66.7% (n = 880) confirmed infection, 19% (n = 251) polytrauma, and 14.3% (n = 189) another etiology. No significant correlation was found between any clinical variable and lactate values (r Mención de responsabilidad : Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes Referencia : Shock. 2018 Sep;50(3):286-292. DOI (Digital Object Identifier) : 10.1097/SHK.0000000000001066 PMID : 29206763 En línea : https://journals.lww.com/shockjournal/fulltext/2018/09000/Association_of_Clinica [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4199 Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality [documento electrónico] / Jessica María Londoño Agudelo, ; Elisa Bernal Sierra, ; Fabián Alberto Jaimes Barragán, . - 2018.
Obra : Shock
Idioma : Inglés (eng)
Palabras clave : Hyperlactatemia lactic acid multiple trauma oxygen consumption patient outcome assessment resuscitation sepsis shock vasopressors Resumen : Background: Lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination may replace it as screening tool. We have determined the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 h of resuscitation; and the association between clinical parameters, lactate, and mortality. Methods: Prospective cohort study of adult patients hospitalized in the emergency room with infection, polytrauma, or other causes of hypotension. We measured serum lactate, capillary refill time, shock index, and pulse pressure at 0, 6, and 24 h after admission. A Spearman's correlation was performed between clinical variables and lactate levels, as well as between changes in clinical parameters and lactate clearance. The operative characteristics of these variables were determined by area under the receiver operating characteristic curve analysis and the association between lactate, clinical variables, and mortality through logistic regression. Results: A total of 1,320 patients met the inclusion criteria, 66.7% (n = 880) confirmed infection, 19% (n = 251) polytrauma, and 14.3% (n = 189) another etiology. No significant correlation was found between any clinical variable and lactate values (r Mención de responsabilidad : Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes Referencia : Shock. 2018 Sep;50(3):286-292. DOI (Digital Object Identifier) : 10.1097/SHK.0000000000001066 PMID : 29206763 En línea : https://journals.lww.com/shockjournal/fulltext/2018/09000/Association_of_Clinica [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4199 Reserva
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